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A Pooled Analysis of Sequential Therapies with Sorafenib and Sunitinib in Metastatic Renal Cell Carcinoma

Frank Stenner, Rahel Chastonay, Heike Liewen, Sarah R Haile, Richard Cathomas, Christian Rothermundt, Raffaele D Siciliano, Susanna Stoll, Alexander Knuth, Tomas Buchler, Camillo Porta, Christoph Renner & Panagiotis Samaras

abstract Objective: To evaluate the optimal sequence for the receptor tyrosine kinase inhibitors (rTKIs) sorafenib and sunitinib in metastatic renal cell cancer. Methods: We performed a retrospective analysis of patients who had received sequential therapy with both rTKIs and integrated these results into a pooled analysis of available data from other publications. Differences in median progression-free survival (PFS) for first- (PFS1) and second-line treatment (PFS2), and for the combined PFS (PFS1 plus PFS2) were examined using weighted linear regression. Results: In the pooled analysis encompassing 853 patients, the median combined PFS for first-line sunitinib and 2nd-line sorafenib (SuSo) was 12.1 months compared with 15.4 months for the reverse sequence (SoSu; 95% CI for difference 1.45-5.12, p = 0.0013). Regarding first-line treatment, no significant difference in PFS1 was noted regardless of which drug was initially used (0.62 months average increase on sorafenib, 95% CI for difference -1.01 to 2.26, p = 0.43). In second-line treatment, sunitinib showed a significantly longer PFS2 than sorafenib (average increase 2.66 months, 95% CI 1.02-4.3, p = 0.003). Conclusion: The SoSu sequence translates into a longer combined PFS compared to the SuSo sequence. Predominantly the superiority of sunitinib regarding PFS2 contributed to the longer combined PFS in sequential use.
   
citation Stenner F, Chastonay R, Liewen H, Haile S R, Cathomas R, Rothermundt C, Siciliano R D, Stoll S, Knuth A, Buchler T, Porta C, Renner C, Samaras P. A Pooled Analysis of Sequential Therapies with Sorafenib and Sunitinib in Metastatic Renal Cell Carcinoma. Oncology 2012; 82:333-340.
   
type journal paper/review (English)
date of publishing 02-6-2012
journal title Oncology (82/6)
ISSN electronic 1423-0232
pages 333-340
PubMed 22677881
DOI 10.1159/000338001